Food and medicine interaction
Fish oil and omega-3 supplements and warfarin and other anticoagulants
ProbableEvidence level: probable. Case reports in people plus a known mechanism, but no controlled studies.
Last reviewed
What can happen
High doses of omega-3s may add to bleeding tendency with anticoagulants, though a small randomized trial of 3 to 6 g of fish oil a day found no significant change in INR in people on stable warfarin.
- Why it happens
- Omega-3 fatty acids can reduce platelet aggregation.
- At ordinary food amounts
- Eating fish is not the concern. The interaction question is about supplement doses of several grams a day.
What to do
Tell your prescriber or anticoagulation clinic before starting a fish oil supplement, and have your INR checked as they advise.
Never stop or change a prescribed medicine without talking to the prescriber.
Common questions
Can I have fish oil and omega-3 supplements while taking anticoagulants?
Tell your prescriber or anticoagulation clinic before starting a fish oil supplement, and have your INR checked as they advise. Eating fish is not the concern. The interaction question is about supplement doses of several grams a day.
Sources
Related
- RemedyOily fish: the full evidence pageSalmon, sardines, mackerel and their kin are the main food source of the omega-3s EPA and DHA. The case for eating them is stronger than the case for fish oil capsules.
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